I've written about health care for more than two decades, starting from my native Iowa where I covered the presidential campaign bus rides of Bill and Hillary Clinton through the Hawkeye state talking health reform and the economy. I have covered the rise, fall and rise again of health reform, chronicling national trends as well as the influence of Barack and Michelle Obama from Chicago's South Side on changes to the U.S. health system from my base in Chicago. I am the author of the new Forbes signature series book, "Inside Obamacare: The Fix For America's Ailing Health Care System." I was health care business reporter at the Chicago Tribune (1998-2011) and previously wrote for Modern Healthcare magazine when first arriving in Chicago in 1993. Prior to that, I wrote for several Iowa newspapers including the Des Moines Register. These days, I contribute stories to the New York Times, Chicago Medicine magazine and teach in the University of Iowa School of Journalism MA in Strategic Communication program. You can see me nationally on Fox News Channel's "Forbes on Fox" show. In Chicago, you can hear my health segments and business analysis on WBBM newsradio 780 and 105.9 FM. I am passionate about health literacy when it comes to explaining the complexities of health care. A better understood health system may save someone some money or their life.

Any Insurer Angst On Obamacare Subsidies May Emerge This Week

If there is any anxiety from the health insurance industry in regard to the potential for certain Americans who signed up for medical coverage on the federally-run exchange to lose coverage, it could emerge later this week.

A parade of publicly-traded health insurance companies are expected to report their second-quarter earnings this week and many of them are expected to update Wall Street analysts and investors on their expansion plans. Already, UnitedHealth GroupUnitedHealth Group has said it will be doubling the number of markets where it plans to offer plans on government run exchanges.

At issue is a three-judge federal appeals court panel’s ruling late week that said insurance premium subsidies paid to Americans who bought coverage under the Affordable Care Act via a federally-run in exchange in 36 states was illegal. The panel said a ruling from the Internal Revenue Service that allows subsidies to be paid in states relying on the federal exchange was essentially illegal.

Though another federal appellate court in Virginia contradicted the U.S. District Court of Appeals for the District of Columbia on the same day and there is no immediate impact on those who bought coverage via the federal exchange currently, the rulings could cause turmoil in the marketplace as health plans are deciding where to offer coverage and where to expand and market their plans going forward.

“In the near term, we expect these decisions to create substantial confusion about the validity of subsidies for plans already purchased on exchanges in the 36 states with federally run exchanges,” Fitch Ratings said in a report last week on the contradicting court rulings. “Offsetting appeals court decisions … raise uncertainty around health insurance exchanges. In the near term, Fitch Ratings expects existing benefits to be questioned and confusion about them to lead to lower enrollment in exchange plans in 2015.”

Five major U.S. health plans report earnings last this week. AetnaAetna (AET) will be the first to do so when it reports its second-quarter earnings on Tuesday followed on Wednesday by HumanaHumana (HUM) and Wellpoint (WLP), a major operator of Blue Cross and Blue Shield plans. Cigna (CI) and Molina (MOH) also are scheduled to announce their earnings this week. UnitedHealth reported its second-quarter earnings and expansion plans earlier this month and hasn’t yet announced any plans to alter those expansions.

Most publicly-trade health insurance companies have either raised earnings or revenue projections in recent quarters as 8 million people signed up for coverage on a health insurance exchange during the first open enrollment period October 1, 2013 through March of this year.

“Without action from the federal government nearly 5 million Americans would receive an average premium increase of 76 percent if the courts ultimately rule that consumers in the federal exchange cannot receive premium subsidies,” Elizabeth Carpenter, director atAvalere Health, a research and advisory services firm on health policy issues tracking the Affordable Care Act in a statement following last week’s court rulings.

“If the ruling is eventually considered and upheld by the Supreme Court, individuals purchasing insurance in states with federally-facilitated exchanges will be impacted,” Avalere’s Carpenter said. “While it remains somewhat unclear how states implementing state-based exchanges but relying heavily on the federal government for exchange operations ( e.g. Idaho, New Mexico, Oregon, and Nevada) would be treated, consumers in a majority of states would be at risk.”

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So, Mr. Japsen, The health insurance companies stand to lose out on those hard earned taxpayers dollars which may filter down to losses for their stockholders. Sorry, tears are hard to come by here as I prefer my tax dollars to actually benefit all citizens. This does not include insurance co. executives, stockholders, and those on the take from Obamacare. Too bad, so sad. Truth is “WE” cannot afford Obamacare and, I believe, even the politicians are facing this as November looms…

What Bruce is saying Lovesmusic, is that, one way or another, insurers will STILL get your tax dollars, either through your involuntary participation, or through the taxpayer-guaranteed bail-out proviso (risk corridors) buried deep within the pages of the law. Seems that no one has given any thought to the power of the hardship exemptions….especially #14, which anyone can claim without one shred of proof. Might I suggest you claim this on your tax form (I had to hold back tears of laughter as I wrote that!) next year as you will be exempt from both having to buy into Barack’s welfare scheme AND payment of any taxes, er, I mean, penalty, er I mean taxes.

While it is true they will still receive taxpayer money in 14 states, their business models were counting on that cashflow from all fifty. It WILL impact premiums in the 14 states that jumped in. We’re already seeing evidence of this in some states. They will be crying over the smaller pile of money.

Lets step back from the entire “the sky is falling” hype and be realistic here for a moment. What the federal courts declared – and may declare , is irrelevant right now , somewhere down the road this will end up at the supreme court and whatever the supreme justices decide is what is going to matter , this however is more than likely not going to happen until after the mid terms. Will the uncertainty about the subsidies affect enrollment during the next open enrollment period ? i say up to a certain extent , people who have pre existing conditions as well as older people will be more than likely take a chance while the younger and more healthy crowd may consider doing without ! But even after the SCOTUS decides that subsidies are only available to the state exchanges the likelihood of people losing their insurance is slim in spite of what the left is trying to tell you . Relief will come from two sides , the insurance companies off course do not want to lose millions of customers and therefore will be looking for ways to reduce premiums in markets covered by federal exchanges and maybe the states may consider some relief measures !

Who created the entitlement state and who sustains it? Democrats! If you lose your job, your coverage, your doctor, your insurance BLAME a Democrat. Next time you go and vote…remember WHO did this to YOU! DEMOCRATS!” Democrats keep adding to the unemployed! People Not In Labor Force Soar To Record 92 Million! Thanks Obama! Thanks spineless Democrats!

this is what happens if you have stupid judges who do not know how to interpret the law or only interpret the law according to their party’s perspective

the republicans should have a majority of both houses, vote REPUBLICAN in the midtern!!! no need to read the names of the running candidate, who cares as long as its REPUBLICAN!!! REPUBLICAN all the way!!! so we could finally get a divorce in the country and SECESSION!!!

Insurers know the gig is up. Their law, ObamaCare, and its bottomless taxpayer trough is going to be cut off very soon- and they know it. This coupled with the fact that more Americans now reject liberal tinkering with free markets means insurers will now lose all the new customers forced to buy their sub-par products. They should have known this would happen, but they let their lust for money override common sense and a viable business model.

So Obvious ! No mis-understanding, Not even a single Democratic Representation for ” We the People” ! Everything is and was a “ MY WAY OR THE HIWAY” Congressional VOTE by the ENTIRE DEMOCRATIC ELECTED INDIVIDUALS, Complete and ZERO, that’s No Other Elected Persons APPROVAL, NEVER BEEN READ, NEVER KNOWING WHAT THIS BILL IS MANDATING OR REQUIRING, JUST ANOTHER OBAMA BRAIN FART, WITH COMPLETE DEMOCRATIC SUPPORT, AND THE TOTAL INCOMPETENCY OF THIS ADMINISTRATION AND TOTAL DISREGARD FOR THE OVERALL AMERICAN PUBLIC AND THEIR WELFARE AND THEIR BENEFIT” . Real Truths, Real Realities, Real Mis-Representations, Real Deceptions, and YES, Even BARE FACED LIES, were used to “GET A DEMOCRATIC, “MY WAY OR THE HIWAY RESULT” !

Statements like this one from the article need to be challenged by the media.

“Without action from the federal government nearly 5 million Americans would receive an average premium increase of 76 percent if the courts ultimately rule that consumers in the federal exchange cannot receive premium subsidies,” Elizabeth Carpenter, director at Avalere Health, a research and advisory services firm on health policy issues tracking the Affordable Care Act in a statement following last week’s court rulings.

That statement is completely untrue. The court decisions will have absolutely no impact on the cost of healthcare or increase anyone’s premium. The only thing that will happen is that people may have to pay their premium instead of having it paid for by other taxpayers. The actual premium will not change.

You have somewhat of a point. Perhaps the analyst should say the subsidized health plan subscriber’s SHARE of the premium will rise 76 percent. But what the person pays (ie: the premium) will certainly go up IF the courts rule that those who bought on the federal exchange cannot be subsidized. These people would likely buy directly from the health plan and get the subsidy another way.

When you hit the public in the pocket book like this law has after so many lies and being shoved down our throats, mind you. Obama said over 35 times at various junctures that we could keep our insurance with great conviction and look at the absolute financial mess we are in now.